A quarterly magazine of urban affairs, published by the Manhattan Institute, edited by Brian C. Anderson.
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Getting It Right on Obesity
Conservatives should promote responsible health choices.
10 March 2010
Two weeks ago in Washington, Left and Right meaningfully debated ideas that could reduce the cost of American health care. Not at the Blair House summit, where the president met with congressional Republicans and exchanged talking points, but a few days earlier, when Mike Huckabee interviewed First Lady Michelle Obama on his Fox News show to discuss her campaign against childhood obesity. Huckabee, as always civil and fair, should be congratulated for taking sides on this important public-health issue, one that todays conservatives often ignore.
It wasnt always this way. Conservative interest in health issues actually goes back a long way. Teddy Roosevelt helped define the American ideal of rugged outdoor sportsmanship. Republican presidents from Eisenhower to Reagan worked to promote national fitness goals. And Huckabee has led by example: as governor of Arkansas, he burned off 100 pounds.
More recently, however, conservatives have tended to shy away from policies promoting health and well-being. Many on the right disdain the liberal food police agenda, but this reaction to government meddling has occasionally led to defending gluttony and self-neglect to the point of pride. Concern over childhood obesity should never result in banning certain foods. But lets remember that freedom also implies responsibility.
The obesity problem is real. In America today, one of three children is overweight or obese. Between 1999 and 2005, the number of hospitalizations attributable to childhood obesity doubled. And obesity before adulthood is connected to a lifelong pattern of illness.
Obesity also has fiscal implications. The fastest way to reduce the national debt is to slow the growth of Medicare and Medicaid costsand that would require that Americans take responsibility for their own diet and fitness, since obesity is a major driver of increased health spending (accounting for roughly one-third of the rise, according to one study).
Many of the first ladys suggestions are reasonable: she wants families to make an effort to have dinner together, for instance. Unfortunately, officials in the Obama administration have also touted ideas that rely too much on big-government solutions. Tom Frieden, now director of the Centers for Disease Control, used his position as New York health commissioner to ban some foods and tax others. There is little evidence that these nanny-state efforts work, but voters may ask what conservatives would do instead. Too many officeholders on the right havent given the matter much thought.
Its time for a constructive platform to help Americans make healthier choices for themselves. We can start by getting government out of the business of subsidizing unhealthy foods. Today, corn is priced about 23 percent below production costs because of Washingtons generosity. A pro-market, pro-local food policy would save Washington money without putting American farmers out of work.
Better diets have been shown to improve test scores and student discipline. Yet school cafeterias are loaded with unhealthy foods. Amazingly, Washington-funded lunch programs practically throw dollars at poor kids to eat junk food. The federal government should stop paying for potato chips.
Government-funded health-care programs make it possible for unhealthy people to pass the costs of their own reckless behavior on to others. Treating the complications of obesity through Medicaid can cost taxpayers more than a patient will pay in taxes over an entire lifetime. Medicaid should thus provide incentives for healthy behavior.
Finally, Americans do need to return to the table: a meal prepared and eaten with your own family, in your own home, is far more likely to be healthy than a meal eaten elsewhere. But theres no government policy that can promote family dinners; only cultural change can influence behavior here.
Liberals are right that the fight against obesity is one that we cant afford to lose. But liberal public-health campaigns will lead to more bureaucracy, higher taxes, and the loss of personal freedom, all without delivering any positive health results.
America was built on rugged individualism. Americans are not helpless victims of food marketing, as too many public-health officials seem eager to claim. Most Americans are tough enough to say no to a second helping if they put their minds to it, just as Mike Huckabee did. Conservatives should learn from his example and take the lead in building a culture of health responsibility.
David Gratzer, a physician, is a senior fellow at the Manhattan Institute.